Determination of Mortality in Cardiac Surgery: Is Cardiac Surgery Scoring (CASUS) System Effective?

Objective: This study was planned to evaluate effectiveness of cardiac surgery score (CASUS) system used for the prediction of mortality after the cardiac surgery and to compare it with EuroSCORE, a tested and approved method. Method: Fifty patients over the age of 18 who came to the intensive care unit (ICU) after open heart surgery and stayed in the ICU for more than 48 hours were prospectively included in the study. After the preoperative EuroSCORE evaluation of the patients, CASUS scoring systems were used for risk scoring from postoperative 0 day to the service or up to the 6th postoperative day (or possible mortality) in patients whose stay in ICU was prolonged. We evaluated the place of both models in the prediction of ICU mortality. Results: The study was conducted with 50 patients- 21 female, 29 male-, aged between 19 and 79 years (mean age: 60.38±12.50). Five (10%) cases exited.The areas under the ROC curve were estimated as follows: EuroSCORE, 45.3%; and for CASUS 0,1, and 2. day scores AUCs of ROC curve were 66,9%, 64,7%, and 79,8%, respectively. The CASUS 2nd day score was found to be valuable in predicting mortality (p<0.01). A statistically significant relationship was observed between the days of stay in the ICU and mortality. Conclusion: Our results show that the rate of the accurate prediction of mortality of CASUS is insufficient on postop 0th and 1st day; however CASUS score on postoperative 2nd day has sufficient.predictive accuracy EuroSCORE is not found effective in the prediction of mortality. It is observed that if the duration of stay in ICU is prolonged, it statistically significantly increases the risk of mortality.